Blog | Green Party of Aotearoa New Zealand » Kevin Haguehttps://blog.greens.org.nz
Join a global political movement: the change we need is Green.Tue, 03 Mar 2015 01:11:57 +0000en-UShourly1http://wordpress.org/?v=4.1.1Is the Health Minister accountable to the public? He doesn’t seem to think so.https://blog.greens.org.nz/2014/12/16/health-minister-accountable-public-doesnt-seem-think/
https://blog.greens.org.nz/2014/12/16/health-minister-accountable-public-doesnt-seem-think/#commentsTue, 16 Dec 2014 00:32:54 +0000https://blog.greens.org.nz/?p=31431Lately I’ve been involved in a sort of farcical standoff with the Health Minister, who seems to be under the illusion that I have no right to ask questions about conflicts involving Health Promotion Agency Board member Katherine Rich, and that he in turn has no responsibily to dignify my questions with a proper answer. […]

]]>Lately I’ve been involved in a sort of farcical standoff with the Health Minister, who seems to be under the illusion that I have no right to ask questions about conflicts involving Health Promotion Agency Board member Katherine Rich, and that he in turn has no responsibily to dignify my questions with a proper answer.

Mrs Rich is also the head of the Food and Grocery Council, on whose behalf she has actively lobbied against tighter controls on the junkfood, tobacco and alcoholic industries – industries that are very often the target of the HPAs health promotion activities.

This apparent conflict has caused concern among health researchers for years, all the more so when I discovered recently that she’d never recused herself from a meeting of the HPA in which decisions about junk food, alcohol or tobacco were made.

So I asked Dr Coleman a series of questions about Mrs Rich’s role and the management, or not, of her conflicts of interest at the HPA.

His response has been very much in the vain of John Key’s “yes-we-break-the-laws-around-the-OIA-when-it-suits-us” brand of disrespect for the democratic process.

Here’s just a taste:

After telling me in the House that he wasn’t at all concerned about Mrs Rich’s management of her interests because he’d asked officials to go through the HPA minutes and they were satisfied there was nothing amiss, I asked Dr Coleman a follow up written question:

31 Oct

On what date did Ministry officials communicate to the Minister that they had concluded that in relation to the Health Promotion Agency board minutes “there’s nothing inappropriate in the conduct of any board member in the context of the Crown Entities Act 2004” ?

Answer: It was communicated to my office on 30 October 2014.

Ok, great, so what was that advice? This calls for two more questions:

10 November:

What was the title or titles, format or formats and date of all advice given by Ministry officials to the Minister that said that there was no conflict of interest at the meetings of the Health Promotion Agency board?

What was the full content of all advice given by Ministry officials to the Minister that said that there was no conflict of interest at the meetings of the Health Promotion Agency board?

Answer: The advice was conveyed orally by Ministry officials to my office.

Hmm , not so helpful

Next question (remember, I have to wait a week for each answer)

What in the Health Promotion Agency Board minutes did officials review that led Ministry officials to conclude “there’s nothing inappropriate in the conduct of any board member in the context of the Crown Entities Act 2004” ?

Answer: The content.

I’d say that was pretty rude. But then I received an OIA showing that there was, in fact, written advice to the Minister which he hadn’t previously disclosed; an email, from Health Officials. But because Coleman says this was advice in preparation for an oral question, he didn’t need to tell me about it.

At which point Dr Coleman’s answers became a total farce:

18 November

Is the Ministry of Health responsible for determining whether Health Promotion Agency board members have acted appropriately at Health Promotion Agency meetings regarding conflicts of interest, or is that the responsibility of another agency or person, and if so, who does the Minister hold accountable?

Answer: No.

I don’t know what Dr Coleman is hiding, or what game he thinks he’s playing, but it’s my job to ask him questions and the ones I’ve put to him concern public health and they are serious.

Rules around conflicts of interests and Government appointees on boards exist precisely to protect our institutions from the risk that those in control of the purse strings might think they’re somehow unaccountable, or untouchable. Dr Coleman would do well to start reflecting on that because I have a few more questions for him yet.

]]>https://blog.greens.org.nz/2014/12/16/health-minister-accountable-public-doesnt-seem-think/feed/3Conflicted interests and health promotion; my opinion.https://blog.greens.org.nz/2014/12/11/conflicted-interests-health-promotion-opinion/
https://blog.greens.org.nz/2014/12/11/conflicted-interests-health-promotion-opinion/#commentsWed, 10 Dec 2014 19:56:22 +0000https://blog.greens.org.nz/?p=31386As it happens, I know quite a bit about health promotion. It was an area I worked in prior to becoming an MP. What differentiates health promotion from the strict biomedical model, or from health education, for example, is its focus on communities and risk environments, rather than individual risk factors. That’s because health status […]

]]>As it happens, I know quite a bit about health promotion. It was an area I worked in prior to becoming an MP. What differentiates health promotion from the strict biomedical model, or from health education, for example, is its focus on communities and risk environments, rather than individual risk factors. That’s because health status is not randomly distributed amongst individuals, but rather clustered. Poor health predominates in communities that are disempowered in some way (eg poverty) or exposed to other “risk environments” (including both physical and social environments as well as economic factors).

The two greatest causes of preventable illness and death in New Zealand are tobacco and unhealthy diets. Alcohol does not cause the same amount of health-related harm as these other two, but because of the harm it causes in other parts of society (eg violence) it is also considered one of the “big three”.

What health promotion says is that it is not very helpful just to give individuals information about healthy and unhealthy alternatives. Evidence is strong that this will have little effect. The measures that are successful are more about using law, regulation and other tools to increase the price of these unhealthy products, reduce availability and reduce marketing and normalisation, as well as engage whole communities in creating new community norms and setting health goals.

I was a strong supporter of the establishment of the Health Promotion Agency, and have argued for its role to be expanded. However, the significant criticism I have had is over the composition of the HPA’s Board – it doesn’t have the expertise you would expect for an agency like this, it is stacked with people who seem to be political appointments (a couple of National Party electorate chairs and a former MP, for a start) and at least one person has very substantial conflicts of interests.

Managing conflicts of interest is a common problem in New Zealand. We are a small country and people often end up playing multiple roles in a given sector. This has led to well-developed processes and ethical standards in the corporate and community sectors. In the state sector these have been taken further, with specific duties defined in law. The duties applying to members of the Board of the Health Promotion Agency are set out in the Crown Entities Act 2004, and in related guidance from the State Services Commission and other authorities. They are highly specific both to ensure that such conflicts don’t compromise the actual work of the entity concerned, but also to enable transparency, so that we can all retain trust and confidence in the integrity of the organisation.

In the case of the Health Promotion Agency there are three levels of protection:

All members must declare their “interests’ (what else they’re involved in) at the time of appointment, and then update this as required at every meeting.

At the beginning of each meeting, members of the Board who have a conflict of interest with any paper being presented to the Board or item to be discussed by the Board at that meeting, say so and it is recorded in the minutes.

Any member who has a conflict of interest with an agenda item may not participate in the discussion or decision-making (or do anything else actually) in relation to that item. Very occasionally the person who has a conflict of interest may well be the person around the Board table with the most knowledge and experience about it. The law recognises this and provides for the Chair to permit a member with a conflict of interest to participate if this is in the public interest. However, such a waiver must be in writing prior to the meeting, and must be recorded in the Annual Report of the entity.

Which all brings us to Katherine Rich. When she was an MP I admired Mrs Rich enormously. Even though she was on “the other side” of politics from me, she was a social liberal and was gutsy with it, standing up for human and civil rights in a National caucus that often didn’t seem well-disposed towards them, most famously against the “hollow men” regime of Don Brash.

So I was disappointed to see her take on the role of chief executive of the Food and Grocery Council. The Council is a voluntary organisation of companies involved in the manufacture and distribution of, well, food and grocery products, and exists to advance their interests, including profitability. Many of these products are unexceptional, of course, and I have no knowledge of how Mrs Rich spends most of her days there.

However, the activities that go with her role that I am aware of involve her public advocacy (including engagement with Parliament and Government), on behalf of those members of the FGC who are tobacco companies, alcohol companies and companies manufacturing or distributing food and drink products known to be unhealthy. With her FGC hat on, Mrs Rich has opposed all of the legislative and regulatory measures designed to reduce smoking (display bans, tax increases, plain packaging), has advocated for minimising the effect of alcohol law reform, has opposed taxes on sugary drinks and other regulatory approaches to improving food content, and has also opposed “traffic light” front of pack content labelling on food and drink products. For a start.

These are all classic health promotion measures intended to reduce the risk of the environments around vulnerable communities. These are exactly the kinds of measures we should expect to see supported by New Zealand’s health promotion agency, and because of their contribution to New Zealanders’ health status, should be the top three areas of work. What’s more one of the consistent themes across the FGC’s advocacy on all three product categories, has been the line pioneered by the tobacco industry that everything’s a matter of individual choice. This theory of individual choice is not supported by evidence, and is completely at odds with the health promotion “risk environments/social determinants” approach we should expect to see from the HPA.

I argue (and I’m not alone – essentially the entire health promotion sector, and the wider public health community agree with me) that Mrs Rich’s role in the FGC, and the activities it has required her to undertake, constitute a serious conflict of interests with the work of the HPA, and her responsibilities as a member of its Board. Essentially her job at the FGC is to maximise consumption (or at least profitability) for her members, including those involved in tobacco, alcohol and unhealthy foods, whereas the HPA’s job is to minimise consumption of products from those same companies. I cannot imagine a more direct and unambiguous conflict of interests.

What the record shows is that Mrs Rich appears to have been assiduous in the first of her duties around conflicts of interest – she has maintained the record of her “interests” in the HPA Board’s Register of Interests. Unfortunately, there it stops. She has never declared a conflict of interest with any item on a HPA Board agenda, despite every single Board meeting considering some aspect of strategy or approach around tobacco, alcohol or food. She has never withdrawn from discussion or decision-making over a single item on the Board’s agenda. No “public interest” waiver from the requirements of the law has ever been recorded in the minutes of the Board or in the HPA’s Annual Report, which Board Chair Lee Mathias would be obliged to record if she’d granted Mrs Rich such a waiver

In other words Katherine Rich has maintained that she has no conflict of interest, and this appears to be accepted by Ms Mathias and by Jonathan Coleman, the Minister of Health. In a way I feel a bit sorry for Jonathan Coleman. He wasn’t the person who appointed the HPA Board, and Mrs Rich may well be a personal friend of his. But he has chosen to be flippant, rather than give genuine answers to parliamentary questions, and to refuse to investigate the matters I have raised.

In particular he has noted that the Board chair, Lee Mathias, must tell him if there has been a conflict of interest, and as she hasn’t then there’s nothing to see here. What this is about, of course, is making Lee Mathias the “fall guy”. That hasn’t stopped him asking the Ministry of Health, apparently, to check over the HPA minutes to see if he has anything to worry about. He tells us they found nothing. In answer to my written questions, however, he was forced to admit that the Ministry has no authority to investigate breaches of the Crown Entities Act by Board members. That’s right. It’s the State Services Commission who would normally undertake such an investigation. Except they can’t initiate one. The Minister must ask for it; Coleman refuses to do so.

So we’re left with Mrs Rich’s assertion, despite all the evidence, that she has no conflict of interest whatsoever, while neither of those who could take action to investigate, Lee Mathias or Minister Coleman, is prepared to. That’s why I have taken my concerns to the Office of the Auditor-General.

Before closing I want to just cover off some defences mounted by Mrs Rich’s supporters.

One person has pointed out that the FGC represents lots of companies that don’t manufacture or distribute these big 3 health threats, and may even make a positive contribution. Sure, that’s true. But for the case for conflict of interest to be made out it isn’t necessary that everything in a person’s other roles is in conflict with the role in question. Just one conflict is enough, and Mrs Rich’s are multiple.

Some have pointed out that this government has been clear that it wants to make progress on improving health by working with industry, rather than independently of it. I first respond by pointing out that “working with industry” does not require industry to be on the Board of our Health Promotion agency, and secondly note that, even if Government were to use this unusual Board membership strategy to achieve constructive engagement, that would not in any way change what constitutes a conflict of interest under law, nor the legal duties that would arise from one.

Finally some have noted that Mrs Rich is very highly regarded by fellow Board members and staff, some saying she makes the best contribution to Board meetings of any member. I can well believe it. She is a very skilled and smart operator. But the law doesn’t say “you’ve made a great contribution so we’re going to disregard your legal duties”.

The legal duties exist both to ensure integrity of the entity itself, and also to maintain public trust and confidence in the State itself. Those both seem quite important to me.

]]>https://blog.greens.org.nz/2014/12/11/conflicted-interests-health-promotion-opinion/feed/2Thanks for your supporthttps://blog.greens.org.nz/2014/09/23/thanks-support/
https://blog.greens.org.nz/2014/09/23/thanks-support/#commentsTue, 23 Sep 2014 05:58:41 +0000http://blog.greens.org.nz/?p=31083So we’re a couple of days on from Saturday night’s results. I’ve had a bit of sleep, which has helped, but I’m still experiencing a roller coaster of emotions. As the person in our Caucus with overall responsibility for planning and strategy, I am really proud of the job we all – MPs, staff and […]

]]>So we’re a couple of days on from Saturday night’s results. I’ve had a bit of sleep, which has helped, but I’m still experiencing a roller coaster of emotions.

As the person in our Caucus with overall responsibility for planning and strategy, I am really proud of the job we all – MPs, staff and volunteers – did over the past three years, both in the House and in the community. That performance was solidified in a great campaign. I can’t think of any significant mistakes we made or opportunities we failed to seize. We left everything out on the field, as they say. Our co-leaders did us proud, our candidates represented us really well, our policy announcements were visionary, practical, well delivered and received, and staff and volunteers right around the country delivered a really well-planned and executed campaign.

So first of all, thank you to everyone who was part of this, and everyone who voted for us.

With a week still to run before the election we appeared to be on track to achieve our target of 15%, with a chance of changing the Government. Poll after poll recorded us at historic high levels. So no wonder we all felt such a sense of deflation and disappointment on Saturday night. We expected to have more opportunity to advance sorely-needed good, green change, and instead we will probably have less. The reviews and analyses of how this happened are getting under way now. My own sense is that people who didn’t engage with the substance of the Greenwald/Snowden revelations felt offended that Mr Dotcom was trying to derail National so close to the election. It seemed like a calculated manipulation of democratic process; they didn’t think it was fair and they responded with a sympathy vote for the Government. That’s one theory anyway! There will be plenty of others, and it will be important that we don’t shrink from self-criticism.

But besides pride and disappointment I am also relieved. John Key may have pulled off (pending specials) a first under MMP of being technically able to govern alone. In the same election Labour’s result is their worst in 90 years. Against this tide we have more or less held our ground. At this point it seems we may have lost an MP, but I am hopeful that Steffan will be back once Special votes are counted. Either way, that still places us close to our best ever election performance.

We’ve worked with the Government to get 235,00 houses insulated, ensure there is better management of toxic sites in New Zealand, forced an investigation into the SkyCity deal, as well as playing a key role in getting authorities to investigate ACC privacy breaches. We managed to get NZ Sign Language recognised in the Standing Orders of parliament. Jan Logie’s ‘Everyone needs the right help’ campaign resulted in more funding for the sector and started a select committee inquiry into sexual violence. We lead the opposition in parliament to the GCSB and the Asset Sales. And after years of Green Party pressure, the huge government banking contract will finally be opened up to get better value for money for the New Zealand public instead of sending all the profits to Australian-owned Westpac bank.

We’ll continue to stand up tall on the issues that matter, and work with other parties where we can find common ground. While another term in opposition is not what we wanted we have still delivered the base for us to immediately regroup. We’ll see what gains may be possible with the new government, be the best Opposition we can possibly be, and change the Government in 2017!

You may be one of the almost half a million voters who has already voted. If you’re not, I certainly hope every person in this room will have voted in the next two days, and that you’ve dragged as many others to the polls as you possibly can. Not voting is not an act of rebellion; it’s an act of surrender.

As you may know I live in Greymouth, and I’m a candidate in the West Coast Tasman electorate, but as with every other Green Party candidate around the country, I am asking not for electorate votes but for your party vote. Party voting Green is the way all of our MPs are elected. If you want to see good Green change. If you want not only a new government, but also a new direction, then please Party Vote Green.

Like you, we love Aotearoa New Zealand!

But there’s plenty of areas where we all need to show our country a bit more love.

It’s not okay that:

61% of the monitored sites on our rivers show water that is unsafe to swim in

The world’s rarest dolphin is at serious risk of extinction on our watch

Our country has no plan and has taken no effective action to combat climate change

More than a quarter of a million children miss out on essentials like food, clothing and access to health services because of poverty

A person can work full time and still not bring home enough money to cover even basic living costs

The Wellington wharf is day-in, day-out piled high with raw logs waiting to be shipped to China, emblematic of our low quality, low wage NZ economy.

The Green Party says we need to show our love for this country with a cleaner environment where our rivers are safe to swim in, a fairer society where every child can thrive and a smarter economy that will work for everyone.

At this election we have announced policies that would deliver:

A wahakura welcome – a sleeping basket, bedding and clothing as a gift from our country to every new born baby. That’s about preventing illness and providing practical help but more importantly it says to new parents “You don’t have to do this alone. Our whole country has a stake in ensuring your child has a great life.”

Backing that up with a non-discriminatory child tax credit and parental tax credit, aimed at alleviating child poverty funded by increasing the top tax rate to 40%

Supporting Sue Moroney’s parental leave bill at 26 weeks, but looking to extend that out to 13 months, like Sweden,

Extending free Early Childhood Education to two year olds

Ensuring that they live in a warm, dry, healthy and secure home through extending OUR home insulation scheme, introducing a warrant of fitness for all rental houses, legislating for better rental security and increasing housing supply to address overcrowding

Dropping power prices through our joint NZPower scheme with Labour, and introducing progressive power pricing to deal with fuel poverty

Using all the tools at the Government’s disposal – even though National will call us a nanny state – to control obesogenic environments, and to drastically reduce the damage alcohol and tobacco are continuing to cause

Making schools hubs for delivery of other services and providing free lunches, free after school and holiday care and dedicated nurses in all decile 1-4 schools

Scrapping pretty well everything in National’s education reforms and returning to the idea of schooling being tailored to the individual needs of each child, along with the resources to make that possible

We have a whole bunch of measures aimed at making it more achievable for all school leavers to move into productive work, study or other training

Massive investment into innovation, research and development to deliver a more diverse, higher wage economy

Better protection for workers and unions

And restoring the natural environment so kids born today will still be able to share our love of nature with their kids.

In the health arena we say:

End National’s erosion of health services, which they have budgeted to continue, by funding health services to keep pace with increasing need

Return investment into public health, primary care and other community-based services, which have been the biggest losers under National

Strengthen and extend Whānau Ora

Make all primary care entirely free up to the age of 18, and after that age more strongly target primary care funding according to need. The principle must be that NOBODY who needs primary care services should be prevented from getting them because of cost

We will reinstate the mental health ringfence and the requirement that all DHBs meet the volume of mental health and AOD treatment services indicated by the Blueprint

We will expand the targets in the Health sector, to focus on what is genuinely important for improving health service quality, rather than what will make the Minister look good

We will address workforce problems through a genuine partnership with health professionals, providers and training organisations

We will mandate safe staffing through CCDM in all hospitals and

We will ensure that all new nursing graduates have a job they can go to

We will close the gap between aged care services and DHB-employed nurses and we will ensure that all workers and all provider organisations are paid fairly for the work they do.

We love New Zealand

We believe it’s time for Government to return to the central purpose of expressing our collective commitment to look after each other and the natural world, and creating a better world for the generations to come, not simply making the economy grow faster.

We will bring a different set of priorities to the decisions Government makes about resource allocation to that which National has used. We will not be spending $20Bn on so-called “roads of national significance”. We will not be giving away $1.1Bn each year in tax cuts for the wealthiest New Zealanders. We will not be selling off strategic public assets for political purposes.

Yes our programme for ensuring every New Zealander can thrive is an expensive one. But it is totally possible to achieve this just by making different value choices to those National has made. The economics consultancy firm Infometrics has independently reviewed our revenue and spending plans, and concluded not only that we can deliver these transformational programmes, but also that we will run a larger surplus and pay down national debt faster than National.

You can make this possible. We have 14 MPs now. Our target is for at least 15% of the Party Vote, which would bring us 20 or more. 20 or more principled, pragmatic and positive MPs who love Aotearoa and will make it better.

]]>https://blog.greens.org.nz/2014/09/18/aotearoa-every-child-can-thrive/feed/0The hidden legacy of debt – our nation’s healthhttps://blog.greens.org.nz/2014/09/05/hidden-legacy-debt-nations-health/
https://blog.greens.org.nz/2014/09/05/hidden-legacy-debt-nations-health/#commentsFri, 05 Sep 2014 04:01:55 +0000http://blog.greens.org.nz/?p=31036Healthcare is expensive. National has lost no opportunity crowing about ‘record spending’ of $14.7 billion in this year’s Budget. Unfortunately, that’s not enough. This National Government has in fact continually underfunded health care relative to real need, this year alone by $232 million. How so? We are getting older, more overweight and more unequal year […]

]]>Healthcare is expensive. National has lost no opportunity crowing about ‘record spending’ of $14.7 billion in this year’s Budget. Unfortunately, that’s not enough. This National Government has in fact continually underfunded health care relative to real need, this year alone by $232 million. How so? We are getting older, more overweight and more unequal year on year – which translates into major health service demand. Baby boomer’s joint operations are due right at the time that renal dialysis for diabetes patients is short, and the A&E is jammed with preventable infections from poor housing. This is happening around the developed world – but if we don’t act now, our health system will collapse, with the medical costs for diabetes alone projected to top $1.8 billion by 2021.

The truth is, to date, we’ve had very low healthcare spending of under $US 4,000 per capita comparable to our health outcomes. This bargain is due to our no-fault ACC social insurance system, our powerful drug bargaining entity PHARMAC, and our historically strong investment in public health and social welfare to provide the necessities of food, warmth and shelter for all. Check out these posters from the 1940s – ‘Children’s Health is the Nation’s Wealth!’ they proudly proclaim.

That is why the Green Party is investing in our healthcare system to meet real need, to the tune of $3.085 billion by 2018. This is instead of National’s election spending promises, because we know healthcare will pay greater long-term dividends than tax cuts or holiday highways. Additionally we have made a $1 billion commitment to reduce child poverty. This includes putting in an extra $21 million for free GP visits and prescriptions for everyone up to 18 years of age; to stop chronic lifestyle diseases in their tracks, before they cost us more in hospitals. We have action plans to tackle diabetes and heart disease across the whole population. Our Healthy Homes package builds on our successful fiscally positive ‘Warm Up NZ’ insulation scheme, which we will extend.

We know ‘healthcare’ can only put expensive bandaids on problems caused by unhealthy lifestyles and poor living standards. This has deeply important economic implications – and is why the fallacy of progressive governments ‘running up debt’ is fiscally incorrect and conceptually wrong. It’s just that National’s debt is hidden in plain sight, in the wards of Starship and the houses of Christchurch East. Children’s health is still our nation’s wealth- and we intend to protect both.

]]>https://blog.greens.org.nz/2014/09/05/hidden-legacy-debt-nations-health/feed/3Health sector raises concerns over TPPAhttps://blog.greens.org.nz/2014/05/13/health-sector-raises-concerns-over-tppa/
https://blog.greens.org.nz/2014/05/13/health-sector-raises-concerns-over-tppa/#commentsTue, 13 May 2014 01:13:35 +0000http://blog.greens.org.nz/?p=30355The Government this week got the message from those in the medical profession that they have significant concerns over the Trans Pacific Partnership Agreement (TPPA). Many of those working in our health services are concerned that the TPPA will undermine Pharmac and thus push up costs on an already squeezed health budget. Other concerns raised […]

]]>The Government this week got the message from those in the medical profession that they have significant concerns over the Trans Pacific Partnership Agreement (TPPA).

Many of those working in our health services are concerned that the TPPA will undermine Pharmac and thus push up costs on an already squeezed health budget.

Other concerns raised by those in our health sector relate to the fact the TPPA contains Investor State Dispute Settlement provisions which allow multi-national corporations to sue Governments.

If legislation is introduced following a trade agreement such as the TPPA multi-national corporations can use these agreements to sue governments.

In Australia tobacco companies have taken legal action to challenge the plain packaging of cigarette packs for health reasons.

It is fantastic that so many dedicated health professionals are pointing out that the TPPA could undermine New Zealand’s ability to pass laws to protect our safety and health.

The TPPA is not just an agreement to enhance trade. It has faced criticism from health professionals, internet freedom activists, environmentalists, and organised labour, because of the way it is being negotiated behind closed doors.

Leaks of the text through wikileaks have so far only raised more concerns about the potential impact of this Agreement on our environmental and health laws.

]]>https://blog.greens.org.nz/2014/05/13/health-sector-raises-concerns-over-tppa/feed/1Reducing child poverty is the best investmenthttps://blog.greens.org.nz/2013/12/12/reducing-child-poverty-is-the-best-investment/
https://blog.greens.org.nz/2013/12/12/reducing-child-poverty-is-the-best-investment/#commentsThu, 12 Dec 2013 00:06:42 +0000http://blog.greens.org.nz/?p=29609With the inaugural Child Poverty Monitor showing that 16 % of kiwi kids will live in poverty for much of their childhood, I was stunned to hear the Social Development Minister say she was “incredibly proud” of her Government’s record for children. Asked if she had a target for reducing child poverty Paula Bennett instead reeled […]

]]>With the inaugural Child Poverty Monitor showing that 16 % of kiwi kids will live in poverty for much of their childhood, I was stunned to hear the Social Development Minister say she was “incredibly proud” of her Government’s record for children.

Asked if she had a target for reducing child poverty Paula Bennett instead reeled off initiative after initiative that supposedly did good things for children, all the while missing the nub of the problem:

If these initiatives are failing to make a difference to the grinding reality of poverty for children; the kind of poverty that means some kids are three times as likely to end up in hospital than others, then what really is the point?

Which is precisely what the Children’s Commissioner was trying to show with his Child Poverty Monitor; if the Government wants to know whether its decisions are working to reduce child poverty, it first needs to measure it. Then it will be accountable for what those measurements show.

The Public Health Advisory Committee recommended the Government set targets for reducing child poverty as far back as 2009, and suggested that the Health Minister should explicitly name child health as his number one priority.

Papers released to me under the OIA show that health officials agreed, and advised the minister that a child poverty measurement would have a significant impact on child health, but the recommendation went nowhere.

Officials also agreed that the recommendation to elevate child health to an explicitly named priority would improve the health of children but, they noted, to do so would, “compete with existing Government priorities”.

Now more than ever it is time for reducing child poverty to be the Government’s main priority, and for children’s health to be the Health Ministry’s top priority.

Reducing Child Poverty and improving child health is an investment in New Zealand’s future, it is not a cost.

]]>https://blog.greens.org.nz/2013/12/12/reducing-child-poverty-is-the-best-investment/feed/11What Tony Ryall doesn’t knowhttps://blog.greens.org.nz/2013/10/31/what-tony-ryall-doesnt-know/
https://blog.greens.org.nz/2013/10/31/what-tony-ryall-doesnt-know/#commentsWed, 30 Oct 2013 21:14:52 +0000http://blog.greens.org.nz/?p=29309A crucial part of the role of any Minister is to know what is happening in their area of responsibility. It seems that Tony Ryall, however, is taking a ‘hear no evil, see no evil’ approach to being the Minister of Health. My previous blog posts on what Tony Ryall doesn’t want to answer and […]

I thought it would be good to put together a list of things that we have asked the Minister about that he doesn’t know the answer to. As you will see, some of them are pretty crucial to our health system.

What the Minister won’t answer:

My letter to him on total obesity funding and whether or not he mislead the House when he said that “we announced a $35.5 million boost of new funding over 4 years for New Zealanders with or at risk of developing diabetes, pre-diabetes, and heart disease. This is in addition to the other funding that the Government invests in initiatives to encourage New Zealanders to make healthy changes to their lifestyles.” We think this $35.5 million is part of the existing funding, not new at all.

My correspondence with his office on the issue of collecting doctor vacancy rates and why he doesn’t do so.

My written questions on what advice he received or sought on various aspects of the Very Low Cost Access scheme. He said “I am kept appraised of the progress of the VLCA scheme in briefings, as appropriate” – which is not exactly an illuminating answer, but one he stuck to under further questioning.

The average case weight (difficulty of the operation) of people on the National Booking Reporting System waiting for surgery or discharged without an operation. This would demonstrate whether or not patients with harder operations are waiting longer at the expense of more operations.

At least he’s pretty consistent with his non-answering. Jan Logie’s questions on the review of standards for doctors’ behaviour in the light of sexual offending against patients got a similar brush off.

It’s impossible to capture in a concise way the extent of Ryall’s obfuscation as the Minister of Health. But his responses here do paint a picture of a Minister who cares more about the politics of health statistics than he does about the actual people which those statistics represent.

]]>https://blog.greens.org.nz/2013/10/31/what-tony-ryall-doesnt-know/feed/4Something great is happening in Courthttps://blog.greens.org.nz/2013/09/20/something-great-is-happening-in-court/
https://blog.greens.org.nz/2013/09/20/something-great-is-happening-in-court/#commentsFri, 20 Sep 2013 00:57:07 +0000http://blog.greens.org.nz/?p=28986A year and a half on from the landmark conference about Alcohol and Other Drug Treatment Courts last year I recently spent a Friday in one of the two that are now operating as pilots. It’s 8.30a.m., we are in the Auckland District Court and Judge Ema Aitken is convening the morning meeting. First off […]

]]>A year and a half on from the landmark conference about Alcohol and Other Drug Treatment Courts last year I recently spent a Friday in one of the two that are now operating as pilots.

It’s 8.30a.m., we are in the Auckland District Court and Judge Ema Aitken is convening the morning meeting. First off I’m struck by how many people are here: besides the Judge and the Court Registrar, there’s a court coordinator, the Police prosecutor, three defence counsel who are assigned to this court and three people from a treatment provider perspective. As we work through each of the cases we are occasionally joined by someone’s solicitor or probation officer.

We start with new applications to become ‘participants’. The Judge kicks each one off by presenting the person’s history and circumstances. We hear from the Police prosecutor about risk of reoffending and risk of imprisonment, and anything in previous convictions that makes them more or less suitable for the programme. There’s lots of drunk driving, burglary, assault, failure to comply with previous sentences. Then we hear from the treatment providers about what treatment regime they are likely to recommend. There’s some frustration I hear about the most appropriate treatment options not always being available. Finally we hear from defence counsel, rounding out the picture, and then a decision is made – in or out. The Court can take up to 50 participants, and currently has about 30. The other pilot in Waitakere has about the same.

Then we move on to review the status of the people who will be appearing in the afternoon. Being an AODTC participant is not an easy option. You have to do treatment. You have to have random drug & alcohol testing. You’re likely to have to do community work, and every two weeks at least, you have to appear before a Judge for a review. As the morning wears on and the pile of thick folders in front of the judge is whittled down I am struck by how well this team knows the participants, and deeply moved by their insight, care and hope. Not all drug court participants are poor, but most are, and problems with income support, transport, housing and so on crop up pretty frequently alongside stories of success or things not going so well

A bit after 12 we break for lunch. Or rather I have lunch – all the Court team have meetings and other prep work, and at 1pm the open court hearing begins with karakia. I’ve spent a lot of time in Court or waiting outside, and this is a familiar feeling. Mostly it’s nerves and anxiety but there’s also smiles here and friendly conversation. Coming back to Court every fortnight, and often being in the same treatment programmes builds relationships between participants. They celebrate each other’s successes, and support each other when it gets hard. In the morning I even saw the team working out which week a particular participant should come back to ensure he would be up at the same time as another successful participant who had become a positive role model.

Maybe I’m lucky. I know that participants often have multiple setbacks on their road to recovery, but on the day I visit most have been doing well. There’s applause when we hear how many days abstinent they’ve been, and lots of positive reinforcement from the Judge. Several have family members who are there to support them. Support workers in the back of the Court work the crowd, talking with the participants, giving them hugs if they need it, occasionally offering helpful comments to Judge Aitken. Several of the women participants have waiata sung for them. The people who are doing well are staying out of prison by being on this programme of course, which is certainly a motivation, but everyone I saw also seemed genuinely proud of their achievement and appreciative of the praise.

That’s not everyone though. One guy on his thirteenth drink driving conviction has returned a positive test for methamphetamine after months of being drug-free, and his explanations just don’t wash. Honesty is critical to the success of the programme – a message I hear many times over in the day. Judge Aitken is very disappointed and tells him so. He must appear the following week to put a case for why he should stay on the programme. Other ‘sanctions’ might be a writing assignment, or a very brief period in the cells It’s a Court after all, and if the participants weren’t on this programme, they would be in the cells.

It’s too early to know how successful this approach will be in reducing recidivism, one of the major goals of the programme, but at the very least it is reducing drug-related harm to some of those who have been most harmed. It must be a bit like being a fan of the Black Caps for Judge Aitken and the AODTC team, lurching between exhilarating success and inexplicable failure, but this is a bold, exciting and compassionate approach to one aspect of criminal justice that might really work. I hope so.

]]>https://blog.greens.org.nz/2013/09/20/something-great-is-happening-in-court/feed/6Rational Tony Ryallhttps://blog.greens.org.nz/2013/09/06/rational-tony-ryall/
https://blog.greens.org.nz/2013/09/06/rational-tony-ryall/#commentsThu, 05 Sep 2013 22:16:40 +0000http://blog.greens.org.nz/?p=28903I am continuing to push the Minister of Health on the issue of planning for diabetes because it is his job to plan for future health services that we need; and he is not doing that. This is a problem for all of us who will inherit, within our lifetimes, an obesity and diabetes crisis […]

]]>I am continuing to push the Minister of Health on the issue of planning for diabetes because it is his job to plan for future health services that we need; and he is not doing that. This is a problem for all of us who will inherit, within our lifetimes, an obesity and diabetes crisis that will totally monopolise our limited health resources. The plain translation of that is that our hospitals will increasingly be filled with people in dialysis machines leaving less room, money, and staff to deal with other health problems.

We should be planning now for this crisis.

Instead of putting his head in the sand, Tony Ryall should be gathering information to give us some sense of just how much diabetes will cost us in the future and what funds we need to devote now to preventing that.

Previously, when I asked him in the House about diabetes prevention, Tony Ryall said:

“Look, I think it would have been rational to have the investment that this Government is making in the area of diabetes and helping people manage their weight. The Government is spending $60 million a year on prevention initiatives, which include Fruit in Schools, the funding for which was going to be stopped under Labour[1]; a range of nutrition and breastfeeding programmes; and a very significant investment in Kiwisport. So it is across the range and across the life course.”

The Minister has never sought nor received any advice on the potential cost of diabetes to New Zealand, so this $60 million figure is just a stab in the dark at some sort or prevention; not based on any analysis of the actual amount of money we should be spending today to address the tidal wave of costs that diabetes is going to hit New Zealand with in the future.

The Ministry of Health has provided the breakdown of that $60 million. It is, in reality, a decrease in budget since 2008 and includes things like increasing spend on bariatric surgery. While that surgery can save lives of people with obesity, it is a treatment, not a prevention measure. It is disingenuous of the Minister to say that he is spending $60 million on prevention measures when actually that is the amount of ‘obesity related expenditure’.

If you take the first 7 lines of that table, which are the actual prevention measures, then we are looking at a 29% reduction in obesity prevention spend all while obesity rates continue to climb.

Notes: This excludes Ministry of Health funding for a range of related programmes and services, such as maternity; maternal and child health services (Well Child, B4SC-Before School Check programmes), PlunketLine; and HealthLine. These services are not specifically designated as nutrition and physical activity programmes or promotion, but they do include advice on improving nutrition and breastfeeding promotion which make a contribution to reducing obesity.This excludes Government funding to district health boards (DHBs) used to employ dietitians. These dietitians provide primarily ‘one-on-one’ nutrition services, and DHBs may use their funding to provide additional nutrition and physical activity programmes and promotion.This excludes funding to general practice for its enrolled population. Advice on nutrition and on reducing obesity is also provided at a community level through general practice.

The Government funds Kiwi Sport $20.5 million of which the Vote Health contribution of $7.462 million Per Annum is identified in the table above.

]]>https://blog.greens.org.nz/2013/09/06/rational-tony-ryall/feed/5A table for one?https://blog.greens.org.nz/2013/09/04/a-table-for-one/
https://blog.greens.org.nz/2013/09/04/a-table-for-one/#commentsWed, 04 Sep 2013 09:12:11 +0000http://blog.greens.org.nz/?p=28893After yesterday’s blog post about the lack of response from the Minister of Health to my written questions it was a nice surprise this morning to see my inbox brimming with responses. Well, sort of. These responses would be funny if they weren’t so sad. The first thing you need to know in order to […]

]]>After yesterday’s blog post about the lack of response from the Minister of Health to my written questions it was a nice surprise this morning to see my inbox brimming with responses. Well, sort of.

These responses would be funny if they weren’t so sad.

The first thing you need to know in order to understand the implications of these responses: the Public Health and Disability Act 2000 sets out that the National Health Committee must establish a committee called the Public Health Advisory Committee to provide independent advice to the Minister and to the National Health Committee.

I asked Tony Ryall, when the last meeting of this committee was – he said “30 November 2009 was the last meeting of the Public Health Advisory Committee before the establishment of new terms of reference for the National Health Committee.”

I then asked him who the current members of the committee are – he took a month to research that complex matter and found out that a Mrs Anne Kolbe is “presently the Chair and sole member of the Public Health Advisory Committee”. She also happens to be the Chair of the National Health Committee which is the body in charge of establishing the Public Health Advisory Committee.

I agree, not very active at all! In fact it could not possibly have been less active. Mr. Ryall has elected not to appoint any members, allocate any Budget, or consider any work programme for the committee. He has let this committee languish because a true public health approach shows up the huge gaps in his work as Minister.

The Committee’s previous work included: New Zealand Evidence for Health Impacts of Transport; Improving Child Oral health and Reducing Child Health Inequalities; The Health of People and Communities – A Way Forward: Public Policy and the Economic Determinants of Health; The Effect of Environmental Factors on the Health of New Zealanders; Men and Health; An Idea Whose Time Has Come (Health Impact Assessment) with a practical how-to guide; Rethinking Urban Environments and Health (and a number of related publications); and The Best Start in Life: Achieving effective action on child health and wellbeing.

What Mr Ryall is missing as Minister is that pulling the focus back on public health is the only way we are going to ensure New Zealand will be a great place to grow up safe, happy and healthy.

]]>https://blog.greens.org.nz/2013/09/04/a-table-for-one/feed/10Tony Ryall and democracyhttps://blog.greens.org.nz/2013/09/03/tony-ryall-and-democracy/
https://blog.greens.org.nz/2013/09/03/tony-ryall-and-democracy/#commentsTue, 03 Sep 2013 05:07:35 +0000http://blog.greens.org.nz/?p=28862I have just sent a letter to the Speaker of Parliament to complain about the apparent disregard with which the Minister of Health, Tony Ryall, has been treating his democratic obligations. Here’s the main gist of my complaint: Every single one of the 101 Questions for Written Answer I have asked the Minister this year […]

]]>I have just sent a letter to the Speaker of Parliament to complain about the apparent disregard with which the Minister of Health, Tony Ryall, has been treating his democratic obligations.

Here’s the main gist of my complaint:

Every single one of the 101 Questions for Written Answer I have asked the Minister this year has come back either unanswered, late, or insufficiently answered.

He has given the answer “I am not able to answer this question within the set timeframe. I undertake to respond to the Member as soon as possible” 50 times!

When a Minister fluffs their answer to a few written questions here or there it’s aggravating, but on Tony Ryall’s scale it starts to pose questions about his ability to do his job.

Some of the answers are over two months late. Considering that the Parliamentary rules state they should be answered within six days, that two month delay is painting a real picture about this Minister.

What is particularly galling about Minister Ryall’s delaying of my most recent set of questions, lodged on the 9th of August, is that they are all regarding an answer to an oral question that I asked the Minister in the House on the 8th of August. I lodged these written questions to clarify the answers he gave. It should be pretty simple to send through the facts that clarify the assertions he made in the House. If he doesn’t have that information then how did he make those claims in the first place?

I asked what the membership of the Public Health Advisory Committee is, what date it last met, and if the Minister intends to resume its work. These answers require little to no research and so his effective refusal to answer points towards him not wanting to answer rather than any sort of problem with timeframes.

There can be no credible reason that the Minister is unable to answer in time as far as I can see, except to hold up the machinery of Parliament and democracy.

]]>https://blog.greens.org.nz/2013/09/03/tony-ryall-and-democracy/feed/20Psychoactive Substances Bill could have been greathttps://blog.greens.org.nz/2013/07/10/psychoactive-substances-bill-could-have-been-great/
https://blog.greens.org.nz/2013/07/10/psychoactive-substances-bill-could-have-been-great/#commentsWed, 10 Jul 2013 07:49:57 +0000http://blog.greens.org.nz/?p=28496For many years the Green Party and many others have been calling for the regulation of drugs to be driven by harm minimisation and health promotion rather than a criminal justice perspective. The evidence is ubiquitous and extremely strong that the “war on drugs” approach does not work to reduce use or harm, and itself […]

]]>For many years the Green Party and many others have been calling for the regulation of drugs to be driven by harm minimisation and health promotion rather than a criminal justice perspective. The evidence is ubiquitous and extremely strong that the “war on drugs” approach does not work to reduce use or harm, and itself causes massive harm and social and financial cost.

We have also said that all drugs – both those currently legal and illegal – should be regulated in a single legal framework.

The Psychoactive Substances Bill is a really major step forward in drug law. It essentially provides for the manufacture, import, distribution, and retail of mind-altering substances provided that they create no more than low risk of harm. The Bill uses a licensing system and provides for various regulatory tools to control retail locations, advertising, sponsorship, packaging and so on. It is clearly possible to subject other substances to the same test and regulate them in the same ways.

Unfortunately, though, some in the Government have clearly not understood their own Bill, or alternatively National has needed to provide comfort to factions with incompatible views, and the result has been several major flaws that leave the Bill not the great piece of legislation it should have been.

Animal Testing – as introduced the Bill would have seen a substantial programme of animal testing, with all the suffering and death that would involve, used to establish the relatively low risk of products. As a result of the campaign led by the Greens in Parliament, supported by others, and animal welfare organisations outside Parliament, LD50 tests were first ruled out, and finally a clause added to the Bill to the effect that animal testing would be unacceptable except where no other suitable test exists. That’s a big advance, but will be hard to monitor and enforce and will essentially end up with Courts having to decide whether alternative tests are good enough. Mojo moved an amendment to instead still require applicants to prove their product was low risk, but without using data from animal testing, essentially setting a higher barrier. Unfortunately this was rejected by National, Peter Dunne and Brendan Horan (and NZ First abstained).

Possession – possession offences are the usual means by which many New Zealanders are criminalised around drugs, and essentially offer no benefits at all. Use or addiction are not reduced, and it becomes harder, not easier to get people connected up with treatment services if they need them. We had consensus on the Select Committee that possession of an unapproved psychoactive substance should not be an offence, and then at the last moment the Government changed its mind. The Bill now contains an infringement offence (essentially like a parking ticket, with no criminal conviction). However the idea of infringement offences is that they provide an instant, minor penalty for small offences, and in the case of psychoactive substances to determine what they are will take literally months so there is no possibility of instant anything, apart from frustration because of confiscation of a substance that will usually turn out to be legal, and a very major hassle for Police.

Transition provisions – There is a delicate balance to be struck concerning the substances currently on sale. Some of them will not meet the ‘low risk’ threshold under the new regime, but we do not want these substances to seed the creation of an underground market as exists for drugs controlled by the Misuse of Drugs Act. The Select Committee’s solution was to provide for an extended period for products currently on sale to continue to be sold in certain retailers for up to 18 months provided that a licence to manufacture or import that substance was approved within that time (and allowing for the product to be withdrawn if it proved more than low risk). Unfortunately the Minister has caved to moral panic and that 18 months has been reduced to just 3. The result is very likely to be the underground market that the Select Committee was trying to avoid.

So a mixed bag. Still worth supporting, but it could have been great. Next we need to work to make it so.

]]>https://blog.greens.org.nz/2013/07/10/psychoactive-substances-bill-could-have-been-great/feed/4Family First gets it wrong on sexuality education alsohttps://blog.greens.org.nz/2013/06/18/family-first-gets-it-wrong-on-sexuality-education-also/
https://blog.greens.org.nz/2013/06/18/family-first-gets-it-wrong-on-sexuality-education-also/#commentsTue, 18 Jun 2013 04:50:18 +0000http://blog.greens.org.nz/?p=28290New Zealand religious right organisation Family First has endeared itself to many with its refreshingly zany approach to evidence when constructing its arguments. Over several issues recently New Zealanders have become familiar with: opinion polls that are more or less useless because of their biased questions essentially moral conservative and religious arguments made to look […]

]]>New Zealand religious right organisation Family First has endeared itself to many with its refreshingly zany approach to evidence when constructing its arguments. Over several issues recently New Zealanders have become familiar with:

opinion polls that are more or less useless because of their biased questions

essentially moral conservative and religious arguments made to look ‘sciencey’ by removing the religious and values words, and inserting academic sounding language and loads of references

references that are wrong, misrepresented, atypical of the literature on a topic or to things that sound like academic journals but are more like lobby group newsletters in reality.

So it was really no surprise to see Family First yesterday release a ‘report’ it had commissioned into several sexuality education resources, from Dr Miriam Grossman. Dr Grossman lives in the United States and is well known there for the extreme religious conservative views she brings to topics of sex and sexuality.

In this case Dr Grossman certainly maintains Family First’s academic traditions. This is actually an older polemic piece, in which Dr Grossman dispensed some cherry-picked ‘facts’ and then gave her opinion about US sexuality education, in which the US-specific programmes have been stripped out and her opinion of a selection of New Zealand resources substituted.

Demolition of Dr Grossman’s work would be a valuable (and fun!) piece of work to do, but I don’t have time for it right now (the scope is enormous and the pickings rich). Suffice to say the following:

The resources that she examines are considered entirely out of the context of the sexuality education programmes in which they are used with young people. A fair examination would start with the New Zealand health education curriculum and then locate the resources appropriately within that.

She does not consider even slightly the intended audience for each of the resources. These are not resources intended for use with all young people but are often highly targeted. For example, there is a website intended for young LGBTI people. The ‘get it on’ campaign from the NZ AIDS Foundation is not even intended for young people at all (it’s for gay and bisexual men).

Dr Grossman’s use of data is highly selective and misleading. For example, on the effectiveness of condoms she selects individual studies (out of literally thousands) that support her perjorative conclusions (a study from rural Uganda, anyone?) In some cases (e.g. discussion of anal intercourse) her values are even more exposed. I’m not saying it’s wrong for her to have a values-based opinion about these subjects. But I am saying it’s wrong for this to be presented as a scientific analysis.

Evaluations of the resources are entirely absent. Did they achieve what they set out to do, or not? Surely that should be the point?

This last point is especially important, because Family First are now spinning Dr Grossman’s ‘report’ as meaning that sexuality education programmes in New Zealand are increasing (presumably underage) teenagers’ sexual activity. In fact she doesn’t say this, but nonetheless, such a theory could only be tested by using outcome evaluations.

In fact a lot of evaluation work has been conducted. It probably wasn’t cited because its conclusions weren’t convenient for the author (or I’ll concede it could just be incredibly lazy scholarship) or her sponsors. The Ministry of Health commissioned an extensive literature review in 2008 to determine effective sexuality education. The literature review identified that effective sexuality education programmes:

recognise that sexuality is integral to the health and well−being of all individuals, including children and adolescents, begin early and are developmentally appropriate

recognise that youth are willing and able to make responsible decisions regarding their sexual health

focus on the promotion of sexual health and positive sexual relationships as opposed to sex−negative behaviours and consequences

encompass a broad−based approach that moves beyond the individual and the physical and considers the wider social, economic and cultural influences on sexual health, behaviour and choices

Our problem in New Zealand is not that the resources produced by great organisations like Family Planning and Rainbow Youth are wrong. It is that we know what works but have failed to ensure that every school uses a sexuality education approach consistent with these criteria.

]]>https://blog.greens.org.nz/2013/06/18/family-first-gets-it-wrong-on-sexuality-education-also/feed/18Health Budget predictions and alternativeshttps://blog.greens.org.nz/2013/05/16/health-budget-predictions-and-alternatives/
https://blog.greens.org.nz/2013/05/16/health-budget-predictions-and-alternatives/#commentsThu, 16 May 2013 01:09:29 +0000http://blog.greens.org.nz/?p=27986As I write this I am preparing to go into Parliament to hear the Budget, and no doubt to see Government Ministers crowing about “more money than ever before” spent on Health, and ‘brave new’ programmes for this and that. I only get the Budget documents once I’m actually in Parliament, and have to frantically […]

]]>As I write this I am preparing to go into Parliament to hear the Budget, and no doubt to see Government Ministers crowing about “more money than ever before” spent on Health, and ‘brave new’ programmes for this and that. I only get the Budget documents once I’m actually in Parliament, and have to frantically start digging through to see what’s actually been increased and – more likely – what’s been cut. Government changes the expenditure lines, the names of the funding, from year to year making this as difficult as possible and trying to guarantee positive media coverage that’s more or less unopposed.

So before that unseemly scramble and the inevitable focus on detail here are some big picture observations on what I expect to be in the budget and what I would do differently. By the time you read this you will be able to tell how accurate I was!

There will indeed be more money spent on Health than ever before – in dollar terms. The reality though is that in each of its budgets so far, this Government has put significantly less into Health than is necessary to “tread water” or retain the system’s capacity to respond to need. Each year we have an older population with greater needs, where costs have risen at the rate of “medical inflation” (significantly higher than the CPI, the normal measure of inflation). Government budgets have not kept pace, meaning erosion of capacity. I believe services must at least maintain parity, and that Health should be a higher funding priority than, say, Roads of National Significance.

There has been genuinely new money for only a very small number of services, most notably elective surgery, which Health Minister Tony Ryall uses as more or less the sole indicator of system performance, even though it comprises only about 5% of what the system does. In the context of a sinking lid on funding this means that these increases occur at the expense of everything else. If I were facing a sinking lid – or even just constrained resources – I would ensure that the prioritised services were those that reduced the need for other services in the long run. This is not what the Minister is doingat all.

There has been a decades-long consensus that the best value for money and most important priority for Health spending has been in Public (preventive) health services and primary care. Over time these areas were being gradually increased at the relative cost of more highly specialised services. Minister Ryall has reversed this direction and I expect to see more of that today. The most important services are being cut to fund Minister Ryall’s pet projects. I would prioritise long-term and durable health gain over short-term political priorities.

The National Government has shown some glimmering of understanding that collaboration between different sectors might be helpful in achieving health (and other) gains. Just maybe we might see some funding and impetus given to that ‘whole of Government’ work. I certainly hope so. This would be a high priority for me. People do not live their lives as isolated individuals or in sector-based compartments. Damp overcrowded houses for example have terrible and expensive health consequences.

One of the consequences of the National Government getting its spending balance wrong in Health has been that inequalities have increased – both in the outcomes themselves, and the factors that drive the outcomes. Those with the worst health – Māori, Pasifika, people with disabilities, people with low incomes and other marginalised groups have had increasingly worse health. Despite the small gains the Māori party have succeeded in negotiating, I expect this adverse trend to continue today. A fundamental priority for me would be to ensure that those with the greatest need receive the most help. This is a human and citizenship right.

The National Government’s real terms cut to funding primary health care has meant that people pay more to visit their practice nurse or doctor and to get prescriptions filled. I expect to see this increasing privatisation of health services to continue. I think access to primary care is fundamental and that Government should be working to ensure cost is NEVER a barrier to care. And it is cheaper and better for everyone to deal with problems at the level rather than adding to burdens of already stretched hospitals.

And of course now I’ve started a list I can’t stop. I expect more ineffective flailing in health workforce, more inaction in Health IT and continued inadequate response to our aging population and the urgent and unprecedented challenge to health services from obesity-related diseases. Mark my words.

]]>https://blog.greens.org.nz/2013/05/16/health-budget-predictions-and-alternatives/feed/3Christchurch mental health initiative better than “all right”https://blog.greens.org.nz/2013/05/10/christchurch-mental-health-initiative-better-than-all-right/
https://blog.greens.org.nz/2013/05/10/christchurch-mental-health-initiative-better-than-all-right/#commentsThu, 09 May 2013 21:57:34 +0000http://blog.greens.org.nz/?p=27917Seeing images of the extent of the devastation wrecked by the earthquakes on Christchurch was depressing. I couldn’t even imagine how life must be for the people who had to work and raise their families in such tough conditions. So it’s great to see bright splashes of colour with the positive message of caring and […]

]]>Seeing images of the extent of the devastation wrecked by the earthquakes on Christchurch was depressing. I couldn’t even imagine how life must be for the people who had to work and raise their families in such tough conditions. So it’s great to see bright splashes of colour with the positive message of caring and supporting each other dotted around town.

About 500 brightly coloured posters reassure it’s “all right” for people to experience a range of emotions in the post-quakes city and encourages people to reach out to support each other.

“All right” is an excellent and well-timed mental health and well-being project led by Healthy Christchurch, and backed by the Mental Health Foundation and Canterbury District Health Board.

This is the right campaign at the right time for Christchurch. It’s about normalising and acknowledging mental health. It acknowledges what Cantabrians have been through, and are still going through, and promotes the value of checking-in on our mental health and well-being.

Our Green policy on health care sets out the importance of providing support at the earliest stage possible, and this is so important with mental health too.

Our policy takes a holistic approach to understanding mental health and illness. There are a wide range of psychological, social, environmental, and physiological factors that can affect mental health. The degree of social support, financial security, reasonable working conditions, safe and healthy housing, supportive schools and access to appropriate health care can all affect our mental health and how we cope if we become mentally ill. (click here to read more on green health policy)

Research conducted to inform the “all right” campaign demonstrates the wide range of factors weighing on the minds of Cantabrians. Many are still struggling from the “double blow” of the earthquakes, but also the increased stress and anxiety of slow on-going insurance battles. Many respondents mentioned grief for the ‘lost Christchurch’, a third are suffering financial problems as a result of the earthquakes, and fatigue was extremely common.

I know the rest of New Zealand hasn’t necessarily gone through the same experiences, but there are definite well-being tips to reflect on as we head into the winter months. Some of the positive findings include how humour, staying active, eating healthy foods, and appreciating the small things in life really help. Also highlighted were people feeling proud of their family’s increased resilience, their communities feeling stronger, and their renewed appreciation of life. What a great silver lining.

So this campaign has a really simple message, but it couldn’t be more pertinent, now is a really good time for everyone to check in with themselves, with friends and whānau, “are you all right?”

]]>https://blog.greens.org.nz/2013/05/10/christchurch-mental-health-initiative-better-than-all-right/feed/0Marriage Equality: Difference of world viewshttps://blog.greens.org.nz/2013/04/12/marriage-equality-difference-of-world-views/
https://blog.greens.org.nz/2013/04/12/marriage-equality-difference-of-world-views/#commentsFri, 12 Apr 2013 00:32:25 +0000http://blog.greens.org.nz/?p=27584The debate over Louisa Wall’s marriage equality bill has been raging for almost a year now, and I have received thousands of emails and letters, as well as having read many thousands of submissions during the Select Committee process I thought the contrast between those in favour and those opposed was striking, and have blogged […]

]]>The debate over Louisa Wall’s marriage equality bill has been raging for almost a year now, and I have received thousands of emails and letters, as well as having read many thousands of submissions during the Select Committee process

I thought the contrast between those in favour and those opposed was striking, and have blogged on this before. Fundamentally there is a difference of world view: those opposed subscribe to a moral code based, usually, on a particular religious faith, and believe everyone should follow this code, whether or not they share that faith. The mental picture I have is a rigidly conformist New Zealand of the 1950s. By way of contrast those who support the Bill usually have a very clear pluralist world view, in which they see the role of Government as providing a framework for a society of many faiths and codes of behaviour.

The difference between the views of older and younger New Zealanders has been particularly striking. When the Select Committee asked some young people about this, they pointed out that they weren’t even born when Fran Wilde’s Homosexual Law Reform Bill overhauled the law in 1986. It is bizarre to them that LGBT people should be treated any differently from anyone else by the law.

We looked for a graphic way of representing this contrast, and used a “sample” of all the correspondence that arrived in my office over a particular time to create word clouds. It’s not science. It’s not discourse analysis. But it makes the point.

You might wonder why we chose LOVE and FEAR. Love because that basic heart message cropped up again and again (love is love, all love is equal, legalise love etc). Fear, because so many of the arguments being used by many opponents were clearly motivated by fear – fear of change, but also fear of imaginary risks, raised a spectres by one or two opposing organisations who, in my view, have acted entirely unethically and dishonestly.

]]>https://blog.greens.org.nz/2013/04/12/marriage-equality-difference-of-world-views/feed/30The Marriage Equality Bill and religionhttps://blog.greens.org.nz/2013/03/11/the-marriage-equality-bill-and-religion/
https://blog.greens.org.nz/2013/03/11/the-marriage-equality-bill-and-religion/#commentsMon, 11 Mar 2013 00:09:11 +0000http://blog.greens.org.nz/?p=27214One of the themes winding its way through the debate over marriage equality is the relationship between the church and the state. New Zealand has no official religion and great effort has been expended to keep the church out of law-making and the State out of religious matters. So marriage presents an interesting set of […]

]]>One of the themes winding its way through the debate over marriage equality is the relationship between the church and the state. New Zealand has no official religion and great effort has been expended to keep the church out of law-making and the State out of religious matters.

So marriage presents an interesting set of issues, because it is both a religious institution (a sacrament in some denominations) and also a civil one. Two possible approaches to reconciling differences are to remove the church or the state entirely from marriage, but in New Zealand we have taken the view that both have legitimate roles.

While we speak of “the church”, that in fact conceals a considerable complexity. There is a multitude of faiths, denominations within faiths, and congregations within denominations. During the course of the debate over marriage equality it has become abundantly clear that opinions and practices concerning marriage vary very considerably. While the loudest church voice in the marriage equality debate has been from those Christian churches who wish not to marry same-sex couples, the select committee has also heard from many churches who wish to be able to marry same-sex couples and who are prevented from doing so by the current law.

When the Bill was introduced, its proponent, Louisa Wall, was absolutely clear that her intent was not to limit freedom of religious expression, and that has been the Select Committee’s driver also.

Some submitters, largely influenced by the lobby group Family First, which spread propaganda through conservative churches, believed religious freedom would be impacted in three ways. I respond to these concerns in this post:

1. Churches will not be forced to marry same-sex couples against their will

Section 29 of the Marriage Act authorises celebrants to marry couples, but explicitly does not oblige them to do so. One can easily imagine that there are many grounds upon which a particular church or a particular celebrant might object to marrying a particular couple, and since 1955 this provision has enabled them to decline to do so. In all of this time I am not aware of any decision to decline being challenged through the Courts, and it’s easy to see why: couples who wish to marry are looking for a positive experience, not one carried out grudgingly, against the celebrant’s will. Adding to the categories of couples who can marry does not alter, in any way, the law around celebrants declining to marry.

However, Family First found a barrister who thought there was a chance Courts would find that declining to marry a couple on the grounds of sexual orientation would be a breach of the Human Rights Act in relation to the provision of goods and services. While the Human Rights Commission – who would be the body to investigate any complaint of discrimination – has been crystal clear that it would not uphold a complaint of discrimination against a celebrant who declined to solemnise a couple, and the majority of legal opinion supports the HRC position, some reputable legal sources have also said that it’s not possible to say that no court would interpret the existing law in the way that Family First (and many religious folk) fear.

Most of the submissions against Louisa’s Bill expressed the fear that churches would be forced to marry same-sex couples even if it offends their genuine religious belief. While the real risk of this was assessed as being very small indeed, it was clearly nobody’s intention (sorry, not quite nobody – there was one submission arguing churches should be compelled to marry any couples who wished to marry and were legally entitled to do so) that the state should compel churches to act against their beliefs. For that reason the select committee added a clause to put beyond all doubt that any celebrant acting on behalf of or appointed by a church can refuse to marry any couple.

The churches who were concerned and who have examined the revised Bill appear to now accept that there is no risk that they will be required to do anything differently. Unfortunately some have now shifted their ground and are now professing concern for independent celebrants who are not acting on the authority of the church. The fact that some churches (and, of course, Bob McCoskrie and Colin Craig) have shifted ground in this way indicates that their actual position is a homophobic one, and that the ‘arguments’ being used are just window dressing to disguise that. For the sake of completeness though:

The body representing independent celebrants reported an overwhelming majority of its members support the Bill;

The committee received perhaps two submissions from independent celebrants who said they did not wish to solemnise marriages for same-sex couples, in both cases because of personal religious faith;

The Human Rights Commission has made it clear that it would not uphold a discrimination complaint against such celebrants;

If the HRC decision were appealed to a higher Court, most lawyers say the appeal would clearly fail, particularly if the refusal was because of religious or ethical reasons;

It’s hard to imagine a celebrant refusing to marry a same-sex couple because of sheer prejudice (“I hate gays”) without an ethical or religious basis, but I concede that if such a case ever arose it would be interesting to see what the Supreme Court made of the legal balance between the explicit statement not obliging celebrants in the Marriage Act against the more general requirement not to discriminate in the provision of goods and services in the Human Rights Act, and the Bill of Rights Act.

Why on earth would a couple go this rigmarole rather than just finding one of the vast majority of celebrants who wants to marry them?

Let’s also not forget that the position of independent celebrants is very clearly not about the relationship of church and state, or religious freedom. Independent celebrants act as agents of the state, with no qualification.

2. Churches will not be forced to say anything different

As submissions started to come in, we started to see an argument that we hadn’t seen before. Section 56 of the Marriage Act made it an offence to deny the validity of someone’s marriage. This provision, which so far as we can tell has never been used, finds its origin in the belief of the Catholic Church back in the 1950s that only marriages carried out in the Catholic Church were valid. Again, some churches and their adherents had been whipped up into a fear that this provision would be used once Louisa’s bill was passed to persecute and imprison those whose religious belief is that marriage should only be between a woman and a man. While this seemed far-fetched, there was certainly no intent for this to occur, so the select committee has simply recommended the repeal of this section, which seems to serve no useful purpose whatsoever.

3. No change is being made to the law around use of church buildings

Some churches and others could really do with a refresher on the human rights law that New Zealand has had since the 1970s, including the updated prohibited grounds for discrimination that were added 20 years ago. If a church makes its church hall available to the public for hire, if someone sells professional photography services, or if someone sells flowers for a living it has been against the law for them to decline to provide their goods and services on the basis of the sexual orientation of their customer for the past 20 years, and on the basis of the customer’s gender for almost 40 years. Louisa’s bill does not change this in any way. That doesn’t affect churches’ religious space, of course, and again who would want a wedding venue where they weren’t welcome, or a photographer or florist who was unsupportive? Once again these are not real arguments, but are red herrings designed to divert the eye away from the real source of opposition – prejudice.

The select committee has ensured that the State does not encroach on the religious belief or practice of churches. They will not be required to do or say anything different. But, in allowing those churches, denominations and congregations that DO support marriage equality to be able to exercise their beliefs too, this Bill will in fact extend religious freedom. It seems a shame that some in our churches see that as a bad thing.

]]>https://blog.greens.org.nz/2013/03/11/the-marriage-equality-bill-and-religion/feed/8Family First, own goals and desperate measureshttps://blog.greens.org.nz/2013/03/05/family-first-own-goals-and-desperate-measures/
https://blog.greens.org.nz/2013/03/05/family-first-own-goals-and-desperate-measures/#commentsTue, 05 Mar 2013 04:15:57 +0000http://blog.greens.org.nz/?p=27148I guess Family First is in a hard position. They really don’t want Louisa Wall’s marriage equality bill to succeed but they’re faced with a situation where most New Zealanders support it, where it passed its First Reading with an emphatic majority, and where the Select Committee that heard submissions has given the Bill a […]

]]>I guess Family First is in a hard position. They really don’t want Louisa Wall’s marriage equality bill to succeed but they’re faced with a situation where most New Zealanders support it, where it passed its First Reading with an emphatic majority, and where the Select Committee that heard submissions has given the Bill a ringing endorsement.

What makes it harder still for them is that the main argument they have previously used – scaremongering about restriction of religious freedom – has been nullified by the Select Committee’s unanimously agreed changes to the Bill which put it beyond doubt that churches will not be required to do or say anything different to what they do now.

So, it’s no surprise to see Family First stooping to desperate and irresponsible measures and amongst these have been a number of own goals.

Who could forget their theft of “Marry You” by Train (who in fact support marriage equality) on their website? Or their extensive reliance on a “study” on “gay parenting” that was later reviewed as worthless by experts and caused the journal that had published it to apologise, saying it didn’t meet basic scientific standards?

Last week saw more scaremongering, which I responded to on Whale Oil, where Family First supporters were convinced that the words “husband” and “wife” were being outlawed or somehow expunged from New Zealand law. In reality there are some Acts in which gender-neutral language has to be used (as it already is, in most Acts that refer to married couples) in order for the law to make sense, but in about three quarters of the Acts where they appear, those words can be and are being retained.

Another of their recent themes has been that the Select Committee process was rushed. David Farrar at Kiwiblog has very helpfully pointed out that this is nonsense, and that the timetable is essentially set by Parliament’s standing orders.

Today, Mr McCoskrie has published what he thinks is his “smoking gun”, an email from Ministry of Justice officials setting out some timing considerations for producing their report about submissions, which refers to the Committee’s “desire to progress its deliberations quickly”.

Unfortunately Bob has it wrong (yet again). In the sometimes arcane world of Parliament, “deliberation” refers to the specific process whereby select committees make their final decisions about their report and the amendments being recommended to the bill they are considering.

It is certainly true that the Committee did wish to conduct its decision-making process as expeditiously as possible. That is because we wanted to hear as many oral submissions as we possibly could and so extended hearings as close as we could to our reporting deadline of 28 February, which was set by Parliament in August last year. In other words, the tight window the Select Committee set for deliberations was to enable as many submissions to be heard as possible.

In the end, both the departmental report (which summarises the submissions and the issues raised, and makes recommendations to the Committee) and the Committee’s report have been extremely well received.

It’s true that there were people who would have liked to make an oral submission who did not get a chance to (probably more in favour than against, in fact). But I am absolutely confident that every member of the Committee, both those in favour of and against the Bill, would put hand on heart to say that the submissions we heard were a fair reflection of the entire range of arguments that submitters made in their written submissions.

I think most reasonable people would conclude that it is reasonable to stop when hearing more submissions will not add to the Committee’s understanding of the issues.

]]>https://blog.greens.org.nz/2013/03/05/family-first-own-goals-and-desperate-measures/feed/12Police move to protect cyclistshttps://blog.greens.org.nz/2013/03/05/police-move-to-protect-cyclists/
https://blog.greens.org.nz/2013/03/05/police-move-to-protect-cyclists/#commentsMon, 04 Mar 2013 20:49:40 +0000http://blog.greens.org.nz/?p=27114In 2011, I discovered that the Police were failing in their duty of care to cyclists when it came to policing bicycle safety. The Police weren’t keeping any meaningful records on bicycle accidents reported by the public on their Community Roadwatch site. Now that’s changed: This small addition will make the world of difference to […]

]]>In 2011, I discovered that the Police were failing in their duty of care to cyclists when it came to policing bicycle safety. The Police weren’t keeping any meaningful records on bicycle accidents reported by the public on their Community Roadwatch site. Now that’s changed:

This small addition will make the world of difference to cyclists and their future safety; the Police can better manage what they now measure.

This is a small win for cyclists and I promise to keep an eye on the developing trends to ensure the Police are adequately enforcing road safety to protect vulnerable road users like cyclists and pedestrians.

Pedal safely this year using the Roadwatch website to report poor driver behaviour. And don’t forget to explore some of the new great rides we’ve been rolling out of late as part of Nga Haerenga – the New Zealand Cycle Trail.